How Genes Influence The Breakdown Of Adalimumab?

What Is Adalimumab?

Adalimumab is a drug used to treat autoimmune disorders like rheumatoid arthritis, Crohn’s disease, and ulcerative colitis. This drug is sold under brand names like Humira, Amgevita, and Cyltezo.

Adalimumab is available in liquid form and needs to be injected under the skin.

How Does Adalimumab Work?

Adalimumab belongs to a group of medications called Tumor Necrosis Factor (TNF) inhibitors. TNF inhibitors suppress the actions of the Tumor Necrosis Factor, which is a small protein that plays a role in the inflammatory response by the immune system.

The immune system is overactive and produces an excess of TNF in people with autoimmune diseases. This leads to inflammation and pain in the body. By suppressing TNF, adalimumab prevents inflammation and its unpleasant effects.

Side Effects Of Adalimumab

When taken without proper guidance from a doctor, Adalimumab can increase the risk of infections in the body, including tuberculosis, and even lead to death.

Other common side effects of the drug are:

Headaches
Backaches
Nausea and vomiting
Pain, redness, and rashes in the injection site
Upper respiratory infections, including sinuses

Some serious side effects of Adalimumab are:

Vision problems
A tingling or numbing sensation in the limbs
Shortness of breath
Chest pain
Fever and chills
Painful skin sores in the body
Sun sensitivity leading to skin damage
Swelling of the limbs and face
Dizziness and fainting episodes

Interactions With Other Drugs

Adalimumab can interact with other drugs used to treat autoimmune diseases and cause severe side effects.

Some commonly used drugs to treat autoimmune conditions and their symptoms are:

Abatacept
Anakinra
Infliximab
Etanercept
Certolizumab pegol
Golimumab
Azathioprine
Mercaptopurine, 6-MP
Rituximab
Methotrexate

HFE Gene And Adalimumab

The HFE gene (homeostatic iron regulator gene) helps produce the HFE protein. This protein is present in the liver, intestines, and immune cells. It helps control how much iron is absorbed from food and stored in the body.

Studies show that the effect of TNF inhibitors in treating autoimmune diseases varies depending on changes in the HFE gene.

rs2071303 is a Single Nucleotide Polymorphism (SNP) in the HFE gene. People with the G allele of this SNP seem to respond better to Adalimumab when compared to people with the A allele.

Allele	Implications
G	Better response to Adalimumab
A	Normal response to Adalimumab

ATG16L1 Gene And Adalimumab

The ATG16L1 gene (autophagy-related 16 like 1 gene) helps regulate autophagy. Autophagy is a process that the cells use to recycle their worn-out parts and break down unwanted proteins. It also plays a role in the body’s inflammatory response.

rs10210302 is an SNP in the ATG16L1 gene. People with Inflammatory Bowel Disease (IBD) carrying the risk allele T were significantly more prone to use Adalimumab when compared to those with the C allele.

Allele	Implications
T	People with Inflammatory Bowel Disease (IBD) were more prone to use Adalimumab
C	People with Inflammatory Bowel Disease (IBD) had normal usage of Adalimumab

TRAF1 Gene And Adalimumab

The TRAF1 gene (TNF receptor-associated factor 1 gene) plays a role in the survival of cells and cell death (apoptosis).

People with the GG genotype of the TRAF1 (+16860A/G) SNP had lowered levels of clinical response to anti-TNF treatments compared to those with the AG or AA genotypes.

Lowered levels of clinical response to drugs like adalimumab may reduce the effectiveness of the treatment. Such individuals may have to take additional dosages for the medicine to work.

Recommendation To Safely Use Adalimumab

Existing Health Conditions

Make sure to notify your doctor of your existing health conditions:

Diabetes
Tuberculosis
Liver diseases
Cancer in the past or present
Heart failure
Nervous system diseases like multiple sclerosis
Chronic Obstructive Pulmonary Disease (COPD)

Drug Interactions

Adalimumab, when taken along with other autoimmune drugs, can create extreme side effects. Talk to your doctor about your current medications in advance.

Pediatric Use

Adalimumab may increase the risk of infections. If your child is receiving this drug, make sure your child has received all appropriate vaccinations.

Genetic Testing

Genetic testing will help understand a person’s response to adalimumab, including how much of the drug the body accepts and how quickly the drug is eliminated from the body. This will make dosage planning more effective and prevent drug toxicity too.

Analyze Your Genetic Response to Adalimumab

Summary

Adalimumab is a drug used to treat autoimmune conditions by suppressing the actions of the Tumor Necrosis Factors (TNFs).
The common side effects of Adalimumab are headaches, back pain, nausea, and upper respiratory infections.
Some of the severe side effects of Adalimumab are shortness of breath, vision problems, chest pain, painful sores, and fainting episodes.
Adalimumab may interact with many drugs and lead to severe side effects. Exercise caution when you combine this drug with other autoimmune disease medications.
Changes in the HFE, ATG16L1, FCGR3A, and TRAF1 genes can alter a person’s response to adalimumab and increase or decrease the drug’s effectiveness.
Adalimumab can cause severe side effects in people with existing health conditions. It can also cause allergic reactions in a few people.
Adalimumab is only recommended in children who have taken all their vaccinations in the past.
Genetic testing will help understand a person’s response to adalimumab and plan individual dosages better.